Kidney injury during pregnancy: associated comorbid conditions and outcomes
Kidney injury during pregnancy: associated comorbid conditions and outcomes
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DOI：
10.1007/s00404-012-2323-5
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发表时间：
2012-09-01
影响因子：
2.6
通讯作者：
Weingarten, Toby N.
中科院分区：
文献类型：
--
作者：
Gurrieri, Carmelina;Garovic, Vesna D.;Weingarten, Toby N.
为探讨妊娠期肾损伤的特点，对2005年1月1日至2010年12月31日在我院分娩的所有孕妇的病历进行电子回顾性分析。我们确定了那些在怀孕期间或产后30天内发生肾损伤的患者[根据修改的急性肾损伤网络（AKIN）标准定义：血清肌酐（sCr）增加千分之一日元0.3 mg/dL]。在研究期间，54名女性发生肾损伤（估计发生率为0.4%），sCr平均（SD）升高0.46（0.29）mg/dL;大多数损伤为AKIN 1期，sCr一过性升高。大多数妇女（n = 48，87.3%）有大量的预先存在或妊娠相关的共病状况（例如，肾病、高血压、糖尿病），并发症（例如，先兆子痫，HELLP综合征），或可能导致肾损伤发展的复杂产科过程（出血，感染）。两名患者有AKIN 3期损伤：一名先前健康的患者在剖宫产时发生大出血，一名肾移植患者的移植肾恶化并最终在产后衰竭，大多数妊娠相关肾损伤是短暂的，发生在患有大量共病或妊娠并发症的女性中。
To investigate the characteristics of women who have kidney injury during pregnancy.Medical records of all women who gave birth at our institution between January 1, 2005, and December 31, 2010, were retrospectively reviewed electronically. We identified those who incurred a kidney injury [defined by modified Acute Kidney Injury Network (AKIN) criteria: serum creatinine (sCr) increase a parts per thousand yen0.3 mg/dL] during pregnancy or within 30 days postpartum. Identified case records were reviewed in detail.During the study period, 54 women had a kidney injury (0.4 % estimated incidence) with a mean (SD) increase in sCr of 0.46 (0.29) mg/dL; most injuries were AKIN stage 1 with transient increases in sCr. Most of the women (n = 48, 87.3 %) had substantial preexisting or pregnancy-associated comorbid conditions (e.g., kidney disease, hypertension, diabetes), complications (e.g., preeclampsia, HELLP syndrome), or a complicated obstetric course (hemorrhage, infections) that could have contributed to the development of a kidney injury. Two patients had AKIN stage 3 injuries: a previously healthy patient who had a massive hemorrhage during cesarean delivery, and a patient with a renal transplant who had deterioration and eventual postpartum failure of her transplanted kidney.The majority of pregnancy-associated kidney injuries were transient and occurred in women with substantial comorbid conditions or complicated pregnancies.